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Intussusception: Incidence and Treatment—Insights From the Nationwide German Surveillance

Jenke, Andreas Christoph*; Klaaen-Mielke, Renate†ß; Zilbauer, Matthias*; Heininger, Ulrich; Trampisch, Hans; Wirth, Stefan*

Journal of Pediatric Gastroenterology & Nutrition: April 2011 - Volume 52 - Issue 4 - p 446–451
doi: 10.1097/MPG.0b013e31820e1bec
Original Articles: Gastroenterology

Objective: Intussusception (IS) is one of the most common paediatric emergencies, and the best mode of conservative reduction and its exact incidence remains unclear. For different reasons, availability of reliable incidence data are useful and additionally may be fundamental to monitor potential effects of recently introduced rotavirus (RV) vaccines.

Methods: We performed a prospective German nationwide surveillance between January 1, 2006 and December 31, 2007, followed by separate collection of all IS cases in a random sample of 31 clinics for an unbiased estimation of underreporting. For case definition, the Brighton Collaboration (BC) criteria were applied.

Results: A total of 1200 children with at least 1 episode of IS were included. For children younger than 1 year the incidence was calculated to be 60.4/100,000 child-years. The risk for surgery increased 2-fold if the interval between onset of symptoms and first attempt of conservative reduction exceeded 5 hours (95% confidence interval [CI] 1.2–3.1). We also observed a 2.8-fold increased risk for surgery for hydrostatic (CI 1.2–6.4) and a 3.7-fold for barium enema reduction (CI 1.6–8.8) compared to pneumatic reduction. The level of specialisation of the hospital did not influence the success of conservative management.

Conclusions: For children with IS a fast attempt of pneumatic reduction seems to be the optimal management. Considering the current practice we estimated that approximately 104 (CI 46–161) surgical interventions would be preventable in Germany every year. Also, conduction of reliable postmarketing monitoring of the new RV vaccines is now possible based on the provided incidence data.

*Children's Hospital, HELIOS Klinikum Wuppertal, Witten-Herdecke University, Herdecke, Germany

Institute for Clinical Statistics and Epidemiology, Bochum University, Bochum, Germany

University Children's Hospital, Basel, Switzerland.

Received 29 July, 2010

Accepted 3 January, 2011

Address correspondence and reprint requests to Andreas C.W. Jenke, MD, Children's Hospital, HELIOS Klinikum Wuppertal, Witten-Herdecke University, Heusnerstr. 40, D-42283 Wuppertal, Germany (e-mail:

The work was funded by a research grant form GSK Bio and Sanofi Pasteur MSD without any restrictions.

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN